Korean Orthodontist: Take 2

David's cast (Dae-ee-bee-duh) on the left and
Elisabeth's (Eel-lee-jah-beet) on the right. 

Today was our follow-up visit to the MIR Dental Hospital to learn the good orthodontist's diagnosis and treatment plans for David and Elisabeth's jaws/teeth.  As you may remember from a few blogs ago, the kids got lots of x-rays and impressions last time, and we were asked to return today with a translator. So, we did.  A lovely Korean student, whom we shall call "Grace," was assigned by the international office on campus to accompany us.

Anyway, the kids' plaster casts sat on the table between us the whole time, but Dr. Kim didn't refer to them. (I was fascinated by them and took lots of pictures after he left.)  Instead, he showed us the kids' x-rays and photos on the computer, with an impressively complex array of measurements and lines all drawn in.  (They reminded me of a crime scene reconstruction of a gunfight, with bullet trajectories lasered all over). He talked at length to Grace, pointing out various teeth and angles and using lots of hand motions to demonstrate relative jaw size and bite angles. He got some sample appliances down from the shelf (with their accompanying plaster impressions from some anonymous soul) and continued explaining the treatment plan to Grace. After awhile, Dr. Kim seemed to realize that of the 6 of us packed around his small consultation table (in the Maximum Emotion Service room), Grace was about as useful as David and Elisabeth (but far less wiggly). As it turns out, our good Dr. Kim has about the same level of English skill as she does, but he also knows all the key orthodontic (orthodontal?) words in English. Relatively important things for a consultation, like, oh, say, "molars" and "permanent teeth." Grace's desperate, frantic references to her smart phone's translator slowly gave way to a despairing, vacant  look as she finally set the phone down and just nodded a lot. (Reminds me of the time I visited the women's clinic several months ago and my student translator was rather flustered by key words like "menstruation" and "mammogram."  I admire their tenacity and desperate attempts to be helpful and respectful--don't get me wrong.  But the translation situations are usually pretty darn funny.)

For some reason, perhaps from my own years of orthodontia or perhaps my love of learning about forensic anthropology (did you know I considered that as a career?), I understood most of what Dr. Kim was saying and he could clarify pretty well when I asked questions. (Nick had questions and took notes, too, but if you want his version of events he can write his own blog). So, for the grandparents or whoever else out there wondering about the actual CONTENT of what we learned today, read on.

David's custom dental mold.  See any problems? 

David has a small lower jaw relative to his upper jaw (pretty obvious in the side-view photo), resulting in a very deep overbite. (I suspect he inherited his lower jaw from me and his upper one from Nick. Poor kid.) The xrays show that all his wisdom teeth have formed and are tucked nicely into his jaws, though the ones crowded into the bottom jaw have a low chance of getting to stay around. According to the size of his hand's growth plates (remember those hand x-rays?), this boy is going to GROW--perhaps to the size of his father--over the next 3-4 years.  For some reason, this made the Koreans in the room perform a "Waah!" in unison to express their great awe of the boy's enormous Dutch heritage.  Anyway, back to orthodontia. David will get a plastic "activator" that will stimulate lower jaw growth by forcing him to have a more "jaw forward" bite. After a year or two, we'll see if braces or other treatments are needed. The good Dr. Kim said something about grinding down the sides of David's top teeth to create spaces, and perhaps inserting micro-screws into his molars, but I have chosen to selectively ignore that prognosis.

Elisabeth's custom dental mold.  It faces left, if you're wondering.

Elisabeth also has a small lower jaw, but it's vertically short (not very tall), especially in the moral regions. Oops: that's molar regions. Big difference. Apparently, teeth grow until they meet their partner teeth in the opposing jaw, which is a "stop growing now" signal. I never knew that and was thus distracted by the mental image of beavers chewing on trees to keep their teeth of manageable length and wondered if THAT would be today's recommended treatment. I was quickly returned to the discussion by Dr. Kim's show-and-tell with a "bite plate."  Basically, this removable plastic appliance for her top jaw will let her bottom front teeth "think" they've hit their upper companions and pause their desire for growth while the bottom molars will say "Hey! We got lots of room here!  Let's get growing!" or something like that. (Of course, I don't really know what they say, since I don't speak molar or Korean Orthodontist.)  Her hand x-rays confirmed our insightful conclusions about Elisabeth's pubertal progress by showing that her growth plates have started filling in: she has some room for growth, but not a whole lot more--just a couple of years, tops. (I am still doomed to be the shortest one in our family, but at least the average difference will be reduced by Elisabeth). As she grows and her remaining 2 baby teeth are replaced by permanent teeth (the x-rays showed them waiting politely backstage), we'll re-assess her treatment needs in a couple of years.  Oh yes: her teeny wisdom teeth were ever-so-cute on the x-ray.

At this point, dear Grace needed to get back to campus for (something) and the kids needed to offer their mouths to the goddesses of orthodontia for yet more dental impressions.  So while Nick drove Grace back, I dashed between the kids' rooms to embarrass them with photos and to shock the lovely technicians with my camera antics and running commentary.  I really must remember that most Koreans under the age of, oh, 70, understand far more English than they let on. For example, I teased David that the goo oozing out of the holes of the impression device looked a lot like Play-Doh (remember the toys that pump out hair?).  He just rolled his eyes; the technician got wide-eyed and giggled.  Oops. 

Finally, Dr. Kim made "reconstruction" impressions for both kids, which was sort of like molding a mouth guard for hockey. After watching, I figured out that these are the ideal alignments of their jaws; for example, David had to thrust his lower jaw way forward before biting down.  Dr. Kim will build their appliances based on these.  I think.  We'll know more in 2 weeks.  As long as I bring a translator, I guess.  :)